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The Science of the Total Environment Nov 2023Infant mortality is a widely reported indicator of population health and a leading public health concern. In this systematic review and meta-analysis, we review the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIM
Infant mortality is a widely reported indicator of population health and a leading public health concern. In this systematic review and meta-analysis, we review the available literature for epidemiologic evidence of the association between short-term air pollution exposure and infant mortality.
METHODS
Relevant publications were identified through PubMed and Web of Science databases using comprehensive search terms and screened using predefined inclusion/exclusion criteria. We extracted data from included studies and applied a systematic rubric for evaluating study quality across domains including participant selection, outcome, exposure, confounding, analysis, selective reporting, sensitivity, and overall quality. We performed meta-analyses, using both fixed and random-effect methods, and estimated pooled odds ratios (ORs) and 95 % confidence intervals (95%CI) for pollutants (nitrogen dioxide (NO), sulfur dioxide (SO), coarse particulate matter (PM), fine particulate matter (PM), ozone (O), carbon monoxide (CO)) and infant mortality, neonatal mortality, or postneonatal mortality.
RESULTS
Our search returned 549 studies. We excluded 490 studies in the abstract screening phase and an additional 37 studies in the full text screening phase, leaving 22 studies for inclusion. Among these 22 studies, 14 included effect estimates for PM, 13 for O, 11 for both NO and CO, 8 for SO, and 3 for PM. We did not calculate a pooled OR for PM due to the limited number of studies available and demonstrated heterogeneity in the effect estimates. The pooled ORs (95%CI) with the greatest magnitudes were for a 10-ppb increase in SO or NO concentration in the days before death (1.07 [95%CI: 1.02, 1.12], 1.04 [95%CI: 1.01, 1.08], respectively). The pooled OR for PM was 1.02 (95%CI: 1.00, 1.03), and the pooled ORs for CO and O were 1.01 (95%CI: 1.00, 1.02) and 0.99 (95%CI: 0.97, 1.01).
CONCLUSIONS
Increased exposure to SO, NO, PM, or CO is associated with infant mortality across studies.
Topics: Infant; Infant, Newborn; Humans; Air Pollutants; Nitrogen Dioxide; Environmental Exposure; Air Pollution; Particulate Matter; Ozone; Infant Mortality; Sulfur Dioxide
PubMed: 37459995
DOI: 10.1016/j.scitotenv.2023.165522 -
Clinical and Experimental Allergy :... Aug 2023Asthma control is generally monitored by assessing symptoms and lung function. However, optimal treatment is also dependent on the type and extent of airway... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Asthma control is generally monitored by assessing symptoms and lung function. However, optimal treatment is also dependent on the type and extent of airway inflammation. Fraction of exhaled Nitric Oxide (FeNO) is a noninvasive biomarker of type 2 airway inflammation, but its effectiveness in guiding asthma treatment remains disputed. We performed a systematic review and meta-analysis to obtain summary estimates of the effectiveness of FeNO-guided asthma treatment.
DESIGN
We updated a Cochrane systematic review from 2016. Cochrane Risk of Bias tool was used to assess risk of bias. Inverse-variance random-effects meta-analysis was performed. Certainty of evidence was assessed using GRADE. Subgroup analyses were performed based on asthma severity, asthma control, allergy/atopy, pregnancy and obesity.
DATA SOURCES
The Cochrane Airways Group Trials Register was searched on 9 May 2023.
ELIGIBILITY CRITERIA
We included randomized controlled trials (RCTs) comparing the effectiveness of a FeNO-guided treatment versus usual (symptom-guided) treatment in adult asthma patients.
RESULTS
We included 12 RCTs (2,116 patients), all showing high or unclear risk of bias in at least one domain. Five RCTs reported support from a FeNO manufacturer. FeNO-guided treatment probably reduces the number of patients having ≥1 exacerbation (OR = 0.61; 95%CI 0.44 to 0.83; six RCTs; GRADE moderate certainty) and exacerbation rate (RR = 0.67; 95%CI 0.54 to 0.82; six RCTs; moderate certainty), and may slightly improve Asthma Control Questionnaire score (MD = -0.10; 95%CI -0.18 to -0.02, six RCTs; low certainty), however, this change is unlikely to be clinically important. An effect on severe exacerbations, quality of life, FEV1, treatment dosage and FeNO values could not be demonstrated. There were no indications that effectiveness is different in subgroups of patients, although evidence for subgroup analysis was limited.
CONCLUSIONS
FeNO-guided asthma treatment probably results in fewer exacerbations but may not have clinically important effects on other asthma outcomes.
Topics: Female; Pregnancy; Adult; Humans; Asthma; Nitric Oxide; Inflammation
PubMed: 37293870
DOI: 10.1111/cea.14359 -
Cells Aug 2023There is an increasing interest in biomarkers of nitric oxide dysregulation and oxidative stress to guide management and identify new therapeutic targets in patients... (Meta-Analysis)
Meta-Analysis Review
There is an increasing interest in biomarkers of nitric oxide dysregulation and oxidative stress to guide management and identify new therapeutic targets in patients with chronic obstructive pulmonary disease (COPD). We conducted a systematic review and meta-analysis of the association between circulating metabolites within the arginine (arginine, citrulline, ornithine, asymmetric, ADMA, and symmetric, SDMA dimethylarginine), transsulfuration (methionine, homocysteine, and cysteine) and folic acid (folic acid, vitamin B, and vitamin B) metabolic pathways and COPD. We searched electronic databases from inception to 30 June 2023 and assessed the risk of bias and the certainty of evidence. In 21 eligible studies, compared to healthy controls, patients with stable COPD had significantly lower methionine (standardized mean difference, SMD = -0.50, 95% CI -0.95 to -0.05, = 0.029) and folic acid (SMD = -0.37, 95% CI -0.65 to -0.09, = 0.009), and higher homocysteine (SMD = 0.78, 95% CI 0.48 to 1.07, < 0.001) and cysteine concentrations (SMD = 0.34, 95% CI 0.02 to 0.66, = 0.038). Additionally, COPD was associated with significantly higher ADMA (SMD = 1.27, 95% CI 0.08 to 2.46, = 0.037), SDMA (SMD = 3.94, 95% CI 0.79 to 7.08, = 0.014), and ornithine concentrations (SMD = 0.67, 95% CI 0.13 to 1.22, = 0.015). In subgroup analysis, the SMD of homocysteine was significantly associated with the biological matrix assessed and the forced expiratory volume in the first second to forced vital capacity ratio, but not with age, study location, or analytical method used. Our study suggests that the presence of significant alterations in metabolites within the arginine, transsulfuration, and folic acid pathways can be useful for assessing nitric oxide dysregulation and oxidative stress and identifying novel treatment targets in COPD. (PROSPERO registration number: CRD42023448036.).
Topics: Humans; Cysteine; Nitric Oxide; Metabolomics; Arginine; Methionine; Racemethionine; Folic Acid; Homocysteine; Vitamins
PubMed: 37681911
DOI: 10.3390/cells12172180 -
Neurology Nov 2023Approximately 5 million fatalities occur annually due to stroke, along with its substantial effects on patient well-being and functional impairment. Research has... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
Approximately 5 million fatalities occur annually due to stroke, along with its substantial effects on patient well-being and functional impairment. Research has established a connection between extended exposure to air pollutants and ischemic stroke. However, the link between short-term exposure to air pollutants and stroke remains less definitive.
METHODS
A comprehensive search was conducted on MEDLINE, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Sciences databases up until February 2023, without any language restrictions. The inclusion criteria encompassed observational or interventional studies that examined the correlation between short-term exposure to air pollutants (carbon monoxide [CO], sulfur dioxide [SO], nitrogen dioxide [NO], ozone [O]) and particulate matter with diameters of less than 1 µm, less than 2.5 µm, or less than 10 µm (PM, PM, and PM), with the incidence and mortality of ischemic stroke. Short-term exposure was defined as exposure occurring within 5 days of the onset of stroke.
RESULTS
A total of 18,035,408 cases of ischemic stroke were included in the analysis, derived from 110 observational studies. Asia accounted for most included studies, representing 58.8% of the total. By contrast, Europe and the Americas contributed 24.6% and 16.7% of the studies, respectively. Notably, none of the included studies were conducted in Africa. Stroke incidence was significantly associated with an increase in the concentration of NO (RR = 1.28; 95% CI 1.21-1.36), O (RR = 1.05; 95% CI 1.03-1.07), CO (RR = 1.26; 95% CI 1.21-1.32), SO (RR = 1.15; 95% CI 1.11-1.19), PM (RR = 1.09; 95% CI 1.06-1.12), PM (RR = 1.15; 95% CI 1.13-1.17), and PM (RR = 1.14; 95% CI 1.12-1.16). Moreover, an increase in the concentration of NO (RR = 1.33; 95% CI 1.07-1.65), SO (RR = 1.60; 95% CI 1.05-2.44), PM (RR = 1.09; 95% CI 1.04-1.15), and PM (RR = 1.02; 95% CI 1.00-1.04) was associated with an increase in stroke mortality.
DISCUSSION
There is a strong and significant correlation between gaseous and particulate air pollutants and the occurrence and mortality rates of stroke. This close temporal association underscores the importance of implementing global initiatives to develop policies aimed at reducing air pollution. By doing so, alleviate the burden of ischemic stroke and its consequences.
Topics: Humans; Ischemic Stroke; Nitrogen Dioxide; Environmental Exposure; Air Pollution; Air Pollutants; Particulate Matter; Stroke
PubMed: 37758483
DOI: 10.1212/WNL.0000000000207856 -
BMC Pregnancy and Childbirth Dec 2023The occurrence of orofacial Clefts (OFCs) is a congenital disease caused by many factors. According to recent studies, air pollution has a strong correlation with the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The occurrence of orofacial Clefts (OFCs) is a congenital disease caused by many factors. According to recent studies, air pollution has a strong correlation with the occurrence of OFCs. However, there are still some controversies about the current research results, and there is no relevant research to review the latest results in recent years.
OBJECTIVE
In this paper, the authors conducted a systematic review and meta-analysis to explore the correlation between ambient air pollution and the occurrence of neonatal OFCs deformity.
METHODS
We searched Pubmed, Web of science, and Embase databases from the establishment of the database to May 2023. We included observational studies on the relationship between prenatal exposure to fine particulate matter 2.5 (PM2.5), fine particulate matter 10 (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO) and the risk of cleft lip (CL), cleft palate (CP), cleft lip with or without palate (CL/P). the Newcastle-Ottawa quality assessment scale (NOS) was used to evaluate the quality of the literature. Funnel plot and Egger's regression were used to verify the publication bias. Random effect model or fixed effect model was used to estimate the combined relative risk (RR) and 95% confidence interval (95%CI).
RESULTS
A total of eleven studies were included in this study, including four cohort studies and seven case-control studies, including 22,453 cases of OFCs. Ten studies had low risk of bias and only one study had high risk of bias. Three studies reported that PM was positively correlated with CL and CP, with a combined RR and 95%CI of 1.287(1.174,1.411) and 1.267 (1.105,1.454). Two studies reported a positive correlation between O and CL, with a combined RR and 95%CI of 1.132(1.047,1.225). Two studies reported a positive correlation between PM and CL, with a combined RR and 95%CI of 1.108 (1.017,1.206). No association was found between SO, CO, NO exposure during pregnancy and the risk of OFCs.
CONCLUSION
The results of this study showed that there was a significant statistical correlation between exposure to PM, PM, O and the risk of OFCs in the second month of pregnancy. Exposure assessment, research methods and mechanisms need to be further explored.
Topics: Infant, Newborn; Female; Pregnancy; Humans; Air Pollutants; Cleft Lip; Cleft Palate; Air Pollution; Particulate Matter; Ozone; Sulfur Dioxide; Nitrogen Dioxide; Environmental Exposure
PubMed: 38041018
DOI: 10.1186/s12884-023-06104-4 -
Environmental Pollution (Barking, Essex... Jun 2021Stillbirth has a great impact on contemporary and future generations. Increasing evidence show that ambient air pollution exposure is associated with stillbirth.... (Meta-Analysis)
Meta-Analysis Review
Stillbirth has a great impact on contemporary and future generations. Increasing evidence show that ambient air pollution exposure is associated with stillbirth. However, previous studies showed inconsistent findings. To clarify the effect of maternal air pollution exposure on stillbirth, we searched for studies examining the associations between air pollutants, including particulate matter (diameter ≤ 2.5 μm [PM] and ≤10 μm [PM]) and gaseous pollutants (sulfur dioxide [SO], nitrogen dioxide [NO], carbon monoxide [CO] and ozone [O]), and stillbirth published in PubMed, Web of Science, Embase and Cochrane Library until December 11, 2020. The pooled effect estimates and 95% confidence intervals (CI) were calculated, and the heterogeneity was evaluated using Cochran's Q test and I statistic. Publication bias was assessed using funnel plots and Egger's tests. Of 7546 records, 15 eligible studies were included in this review. Results of long-term exposure showed that maternal third trimester PM and CO exposure (per 10 μg/m increment) increased the odds of stillbirth, with estimated odds ratios (ORs) of 1.094 (95% CI: 1.008-1.180) and 1.0009 (95% CI: 1.0001-1.0017), respectively. Entire pregnancy exposure to PM was also associated with stillbirth (OR: 1.103, 95% CI: 1.074-1.131). A 10 μg/m increment in O in the first trimester was associated with stillbirth, and the estimated OR was 1.028 (95% CI: 1.001-1.055). Short-term exposure (on lag day 4) to O was also associated with stillbirth (OR: 1.002, 95% CI: 1.001-1.004). PM, SO and NO exposure had no significant effects on the incidence of stillbirth. Additional well-designed cohort studies and investigations regarding potential biological mechanisms are warranted to elaborate the suggestive association that may help improve intergenerational inequality.
Topics: Air Pollutants; Air Pollution; Environmental Exposure; Epidemiologic Studies; Female; Humans; Nitrogen Dioxide; Ozone; Particulate Matter; Pregnancy; Stillbirth; Sulfur Dioxide
PubMed: 33689950
DOI: 10.1016/j.envpol.2021.116752 -
Revista Brasileira de Enfermagem 2022to map the strategies for managing thirst in postoperative adult patients. (Review)
Review
OBJECTIVES
to map the strategies for managing thirst in postoperative adult patients.
METHODS
scoping review was conducted in October 2021 in 19 data sources: 14 databases and 5 platforms to search in the grey literature. It was prepared according to the recommendations of the Joanna Briggs Institute and the checklist of the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Nine selected articles were part of the final sample.
RESULTS
there is evidence of strategies to manage postoperative thirst using interventions such as water, ice, mentholated measures, carbohydrate and protein enriched fluid, oral hydrator, flavored gargling, cold gargling, wet gauze, 0.75% citric acid spray, and cold water.
FINAL CONSIDERATIONS
the strategies observed may be reduced to cold and menthol use, salivary stimulants, and early introduction of fluids. The outcomes were positive in all the studies reviewed.
Topics: Adult; Carbohydrates; Citric Acid; Humans; Ice; Menthol; Research Design; Thirst; Water
PubMed: 36228294
DOI: 10.1590/0034-7167-2022-0154 -
The Science of the Total Environment Jan 2024The COVID-19 pandemic presents unprecedented challenge for global public health systems and exacerbates existing health disparities. Epidemiological evidence suggested a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The COVID-19 pandemic presents unprecedented challenge for global public health systems and exacerbates existing health disparities. Epidemiological evidence suggested a potential linkage between particulate and gaseous pollutants and COVID-19 mortality. We aimed to summarize the overall risk of COVID-19 mortality associated with ambient air pollutants over the short- and long-term.
METHODS
For the systematic review and meta-analysis, we searched five databases for studies evaluating the risk of COVID-19 mortality from exposure to air pollution. Inclusion of articles was assessed independently on the basis of research topic and availability of effect estimates. The risk estimates (relative risk) for each pollutant were pooled with a random-effect model. Potential heterogeneity was explored by subgroup analysis. Funnel plots and trim-and-fill methods were employed to assess and adjust for publication bias.
FINDINGS
The systematic review retrieved 2059 records, and finally included 43 original studies. PM (RR: 1.71, 95 % CI: 1.40-2.08, per 10 μg/m increase), NO (RR: 1.33, 1.07-1.65, per 10 ppb increase) and O (RR: 1.61, 1.00-2.57, per 10 ppb increase) were positively associated with COVID-19 mortality for long-term exposures. Accordingly, a higher risk of COVID-19 mortality was associated with PM (1.05, 1.02-1.08), PM (1.05, 1.01-1.08), and NO (1.40, 1.04-1.90) for short-term exposures. There was some heterogeneity across subgroups of income level and geographical areas.
CONCLUSION
Both long-term and short-term exposures to ambient air pollution may increase the risk of COVID-19 mortality. Future studies utilizing individual-level information on demographics, exposures, outcome ascertainment and confounders are warranted to improve the accuracy of estimates.
Topics: Humans; Nitrogen Dioxide; Pandemics; Environmental Exposure; COVID-19; Air Pollution; Air Pollutants; Dust; Particulate Matter
PubMed: 37797765
DOI: 10.1016/j.scitotenv.2023.167542 -
Public Health Feb 2023This study aimed to provide evidence of the associations between pre- and post-birth and adulthood air pollution exposure with telomere length. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This study aimed to provide evidence of the associations between pre- and post-birth and adulthood air pollution exposure with telomere length.
STUDY DESIGN
The databases of PubMed, Embase, and Web of Science were searched up to June 1st, 2022 in order to include relevant observational studies and perform a systematic review and meta-analysis.
METHODS
The random-effects meta-analysis was grouped by air pollutant and exposure window (pre- and post-birth and adulthood) to evaluate the summary effect estimate. Cochran's Q and I statistics were used to evaluate the heterogeneity among the included studies. The quality of individual studies was evaluated using the national toxicology program/office of health assessment and translation risk of bias rating tool.
RESULTS
We identified 18 studies, covering 8506 children and 2263 adults from multiple countries. We found moderate evidence that particulate matter less than 2.5 μm (PM) exposure during the entire pregnancy (-0.043, 95% CI: -0.067, -0.018), nitrogen dioxide (NO) exposure during the first trimester (-0.016, 95% confidence interval [CI]: -0.027, -0.005), long-term adulthood PM exposure were associated with shortening telomere length. Mild to high between-study heterogeneity was observed for the most tested air pollutant-telomere length combinations in different exposure windows.
CONCLUSIONS
This systematic review and meta-analysis provides the evidence which strongly supports that prenatal PM and NO exposures were related to reduced telomere length, while prenatal sulfur dioxide (SO) and carbon monoxide (CO) exposures, childhood PM, particulate matter less than 10 μm (PM), NO exposures and short-term adulthood PM and PM exposures were not associated with telomere length. Further high-quality studies are needed to elaborate our suggestive associations.
Topics: Child; Adult; Female; Pregnancy; Humans; Nitrogen Dioxide; Environmental Exposure; Air Pollution; Air Pollutants; Particulate Matter; Telomere
PubMed: 36642039
DOI: 10.1016/j.puhe.2022.11.022 -
Sports Medicine (Auckland, N.Z.) Feb 2015Regular exercise is associated with enhanced nitric oxide (NO) bioavailability. Flow-mediated dilation (FMD) is used widely to assess endothelial function (EF) and NO... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Regular exercise is associated with enhanced nitric oxide (NO) bioavailability. Flow-mediated dilation (FMD) is used widely to assess endothelial function (EF) and NO release.
OBJECTIVES
The aims of this systematic review and meta-analysis were to (i) investigate the effect of exercise modalities (aerobic, resistance or combined) on FMD; and (ii) determine which exercise and participant characteristics are most effective in improving FMD.
METHODS
We searched the MEDLINE, Embase, Cochrane Library, and Scopus databases for studies that met the following criteria: (i) randomized controlled trials of exercise with comparative non-exercise, usual care or sedentary groups; (ii) duration of exercise intervention ≥4 weeks; (iii) age ≥18 years; and (iv) EF measured by FMD before and after the intervention. Weighted mean differences (WMDs) with 95% confidence interval were entered into a random effect model to estimate the pooled effect of the exercise interventions.
RESULTS
All exercise modalities enhanced EF significantly: aerobic (WMD 2.79, 95% CI 2.12-3.45, p = 0.0001), resistance (WMD 2.52, 95% CI 1.11-3.93, p = 0.0001) and combined (WMD 2.07, 95% CI 0.70-3.44, p = 0.003). A dose-response relationship was observed between aerobic exercise intensity and improvement in EF. A 2 metabolic equivalents (MET) increase in absolute exercise intensity or a 10% increase in relative exercise intensity resulted in a 1% unit improvement in FMD. There was a positive relationship between frequency of resistance exercise sessions and improvement in EF (β 1.14, CI 0.16-2.12, p = 0.027).
CONCLUSIONS
All exercise modalities improve EF significantly and there was a significant, positive relationship between aerobic exercise intensity and EF. Greater frequency, rather than intensity, of resistance exercise training enhanced EF.
Topics: Endothelium, Vascular; Exercise; Humans; Nitric Oxide; Randomized Controlled Trials as Topic; Regional Blood Flow; Resistance Training; Vasodilation
PubMed: 25281334
DOI: 10.1007/s40279-014-0272-9